Surgical instrument driving mechanism

ABSTRACT

A robotic surgical instrument comprising a shaft, an articulation attached to the distal end of the shaft, and a driving mechanism at the proximal end of the shaft. The articulation comprises a plurality of joints for articulating an end effector, the plurality of joints driveable by at least first and second pairs of driving elements. The driving mechanism comprises a pulley arrangement and a pulley drive. The pulley arrangement comprises first and second pulleys attached together such that their separation is fixed, wherein the first pair of driving elements is constrained to move around the first pulley, and the second pair of driving elements is constrained to move around the second pulley. The pulley drive is configured to linearly displace the pulley arrangement, such that a linear displacement in one direction away from the distal end of the shaft causes the first pair of driving elements to be tensioned and the second pair of driving elements to be de-tensioned, and a linear displacement in an opposing direction towards the distal end of the shaft causes the second pair of driving elements to be tensioned and the first pair of driving elements to be de-tensioned.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. patent application Ser. No.15/161,345, filed May 23, 2016, titled SURGICAL INSTRUMENT DRIVINGMECHANISM, which claims the benefit under 35 U.S.C. § 119 of UnitedKingdom Patent Application Nos. 1508807.3 filed on May 22, 2015 and1608816.3 filed on May 19, 2016. U.S. patent application Ser. No.15/161,345 and United Kingdom Patent Application No. 1508807.3 arehereby incorporated herein by reference in their entirety for allpurposes.

BACKGROUND

It is known to use robots for assisting and performing surgery. Surgicalrobots normally consist of a base, an arm, and an instrument. The basesupports the robot, and is itself attached rigidly to, for example, theoperating theatre floor, the operating theatre ceiling or a trolley. Thearm extends between the base and the instrument. The arm typically has aplurality of articulations, which are used to locate the surgicalinstrument in a desired location relative to the patient. The surgicalinstrument is attached to the distal end of the robot arm. The surgicalinstrument penetrates the body of the patient at a port so as to accessthe surgical site.

FIG. 1 illustrates a typical surgical instrument 100 for performingrobotic laparoscopic surgery. The surgical instrument comprises a base101 by which the surgical instrument connects to the robot arm. A shaft102 extends between base 101 and articulation 103. Articulation 103terminates in an end effector 104. In FIG. 1 , a pair of serrated jawsare illustrated as the end effector 104. The articulation 103 permitsthe end effector 104 to move relative to the shaft 102. It is desirablefor at least two degrees of freedom to be provided to the motion of theend effector 104 by means of the articulation.

FIG. 2 illustrates an example of a known cabling arrangement 200 in asurgical instrument for transferring drive from the base of the surgicalinstrument 101 through the shaft 102 to the articulation 103. Cable pairC1, C2 terminate in the articulation as a loop around capstan 202. Theythen pass as a pair around one side of capstan 201. From there, thecable pair C1, C2 passes over capstan 204 and down through shaft 102 tothe base of the instrument 101. Cable pair C3, C4 terminate in thearticulation as a loop around capstan 203. They then pass as a pairaround the other side of capstan 201 to C1, C2. From there, the cablepair C3, C4 passes under capstan 204 and down through shaft 102 to thebase of the instrument 101.

Rotation of yoke 205 about capstan 204 causes the articulation 103 andhence the end effector 104 to pitch about the capstan 204. Pitching inone direction is enabled by pulling cable pair C1, C2 and releasingcable pair C3, C4. Pitching in the other direction is enabled by pullingcable pair C3, C4 and releasing cable pair C1, C2. Rotation of capstan202 causes one jaw of end effector 104 to move. Movement in onedirection is enabled by pulling cable C1 and releasing cable C2.Movement in the other direction is enabled by pulling cable C2 andreleasing cable C1. Rotation of capstan 203 causes the other jaw of endeffector 104 to move. Movement in one direction is enabled by pullingcable C3 and releasing cable C4. Movement in the other direction isenabled by pulling cable C4 and releasing cable C3. Cables C1, C2, C3and C4 are driven individually and independently by drivers D1, D2, D3and D4 respectively.

In the context of minimally invasive surgery, it is desirable to reducethe external diameter of the shaft in order to minimise the size of theincision through the skin of the patient and disruption inside thepatient's body. It is also desirable to minimise the weight of thesurgical instrument so as to minimise the size and weight of the robotbase and arm required to support the instrument, thereby enabling therobot as a whole to be more moveable within the operating theatre.

It would therefore be desirable to reduce the size and weight of thedriving mechanism in the surgical instrument whilst retaining theability to articulate the end effector as described above.

SUMMARY OF THE INVENTION

According to an aspect of the invention, there is provided A roboticsurgical instrument comprising: a shaft; an articulation attached to thedistal end of the shaft, the articulation comprising a plurality ofjoints for articulating an end effector, the plurality of jointsdriveable by at least first and second pairs of driving elements; and adriving mechanism at the proximal end of the shaft, the drivingmechanism comprising: a pulley arrangement comprising first and secondpulleys attached together such that their separation is fixed, whereinthe first pair of driving elements is constrained to move around thefirst pulley, and the second pair of driving elements is constrained tomove around the second pulley; and a pulley drive configured to displacethe pulley arrangement, such that a displacement in one direction causesthe first pair of driving elements to be tensioned and the second pairof driving elements to be de-tensioned, and a displacement in anopposing direction causes the second pair of driving elements to betensioned and the first pair of driving elements to be de-tensioned.

Suitably, the pulley drive is configured to displace the pulleyarrangement such that a displacement in one direction causes the firstpair of driving elements to be tensioned and the second pair of drivingelements to be compressed, and a displacement in an opposing directioncauses the second pair of driving elements to be tensioned and the firstpair of driving elements to be compressed.

Suitably, the articulation is a wrist articulation and one of theplurality of joints is a pitch joint configured to pitch the wristarticulation, the first and second pairs of driving elements beingconnected to the wrist articulation such that when the pulley drivedisplaces the pulley arrangement in one direction the wrist articulationpitches in one direction about the pitch joint, and when the pulleydrive displaces the pulley arrangement in the opposing direction thewrist articulation pitches in an opposing direction about the pitchjoint.

The pulley drive may be configured to displace the pulley arrangement ina direction parallel to the longitudinal axis of the shaft.

Suitably, at the proximal end of the shaft, the first pair of drivingelements is constrained to move around the first pulley only with nofurther intervening pulleys, such that when the pulley drive displacesthe pulley arrangement away from the distal end of the shaft, the firstpair of driving elements is tensioned.

Suitably, the second pair of driving elements is further constrained tomove around third and fourth pulleys, the third and fourth pulleys beinglocated further from the articulation than the pulley arrangement,wherein the second pair of driving elements extends from thearticulation through the shaft, around the third and fourth pulleys tothe second pulley, such that when the pulley drive displaces the pulleyarrangement towards the distal end of the shaft, the second pair ofdriving elements is tensioned.

Suitably, the driving mechanism further comprises a first driveconfigured to drive the first pair of driving elements, such that adrive applied in one direction causes a first one of the first pair ofdriving elements to be tensioned and a second one of the first pair ofdriving elements to be compressed, and a drive applied in an opposingdirection causes the first one of the first pair of driving elements tobe compressed and the second one of the first pair of driving elementsto be tensioned.

The first one of the plurality of joints may be configured to actuateopposing first and second jaws of an end effector, the first pair ofdriving elements being connected to the articulation such that when thefirst drive applies a drive in one direction the first jaw rotates inone direction about that joint, and when the first drive applies a drivein an opposing direction the first jaw rotates in an opposing directionabout that joint.

Suitably, the first drive is a linear drive.

The driving mechanism may further comprise a second drive configured todrive the second pair of driving elements, such that a drive applied inone direction causes a first one of the second pair of driving elementsto be tensioned and a second one of the second pair of driving elementsto be compressed, and a drive applied in an opposing direction causesthe first one of the second pair of driving elements to be compressedand the second one of the second pair of driving elements to betensioned.

One of the plurality of joints may be configured to actuate opposingfirst and second jaws of an end effector, the second pair of drivingelements being connected to the articulation such that when the seconddrive applies a drive in one direction the second jaw rotates in onedirection about that joint, and when the second drive applies a drive inan opposing direction the second jaw rotates in an opposing directionabout that joint.

The second drive is a linear drive.

The driving elements may be elongate and flexible. The driving elementsmay be cables. The driving elements may resist compression and tensionforces. Each pair of driving elements may be formed of opposed portionsof a single elongate element secured to one of the plurality of jointsof the articulation. Each driving element of the first pair of drivingelements may be formed of a distinct elongate element secured to one ofthe plurality of joints of the articulation and secured to the firstpulley. Each driving element of the second pair of driving elements maybe formed of a distinct elongate element secured to one of the pluralityof joints of the articulation and secured to the second pulley.

BRIEF DESCRIPTION OF THE FIGURES

The present invention will now be described by way of example withreference to the accompanying drawings. In the drawings:

FIG. 1 illustrates a known surgical instrument;

FIG. 2 illustrates a known cabling arrangement of a surgical instrument;

FIG. 3 illustrates a driving mechanism at the end of the surgicalinstrument distal from the end effector;

FIG. 4 illustrates the driving mechanism of FIG. 3 as applied in anarticulated surgical instrument; and

FIG. 5 illustrates a driving mechanism at the end of the surgicalinstrument distal from the end effector.

DETAILED DESCRIPTION

FIG. 3 illustrates a schematic drawing of an exemplary driving mechanism300 of the interior of a robotic surgical instrument at the end of thesurgical instrument distal from the end effector. The surgicalinstrument as a whole has the general form shown in FIG. 1 . In otherwords, the surgical instrument comprises a base 101 by which thesurgical instrument connects to the surgical robot arm. The instrumentbase is designed cooperatively with the terminal end of the surgicalrobot arm, such that the instrument base is releasably attachable to theterminal end of the robot arm. A shaft 102 extends between the base 101and an articulation 103. The articulation 103 is connected at itsproximal end to the shaft 102 and at its distal end to an attachmentsuitable for attaching an end effector 104. The shaft 102 andarticulation 103 are all hollow. This allows passage of elements upthese sections to actuate the end effector 104. It also reduces theweight of the surgical instrument.

The end effector may take any suitable form. For example, the endeffector may be smooth jaws, serrated jaws, a gripper, a pair of shears,a needle for suturing, a camera, a laser, a knife, a stapler, acauteriser, a suctioner.

The driving mechanism of FIG. 3 is arranged to drive two pairs ofdriving elements, E1, E2 and E3, E4. The driving elements may, forexample, be cables. The driving mechanism of FIG. 3 enables the fourdriving elements E1, E2, E3 and E4 to be driven using only three drives,301, 302, 303.

The driving mechanism of FIG. 3 comprises a pulley arrangement 304 whichcouples together the two pairs of driving elements E1, E2 and E3, E4.Pulley arrangement 304 comprises two pulleys 305 and 306 connected byarm 307. Arm 307 connects pulleys 305 and 306 together such that theirseparation is fixed. Arm 307 is rigid. The pulleys 305 and 306 arerotatably mounted to the arm. Each of the pulleys 305 and 306 rotatesrelative to the arm 307 independently of the other pulley 305 or 306. Inthe example shown in FIG. 3 , the pulleys 305 and 306 are arrangedparallel to each other in the same plane. Each pulley has two opposingcircular faces separated by a grooved edge for receiving the drivingelements. The pulleys are arranged such that their circular profiles arein the same plane. The pulleys 305 and 306 are edge on. The facingsurfaces of the pulleys are their grooved edges. The centre of pulley305 is rotatably mounted to the arm 307 such that pulley 305 rotatesabout an axis 308 which is perpendicular to the circular faces of thepulley 305. The only permitted motion of pulley 305 relative to the arm307 is rotation about axis 308. The centre of pulley 306 is rotatablymounted to the arm 307 such that pulley 306 rotates about an axis 309which is perpendicular to the circular faces of the pulley 306. The onlypermitted motion of pulley 306 relative to the arm 307 is rotation aboutaxis 309. Axes 308 and 309 are parallel to each other. The pulleyarrangement is arranged longitudinally in the shaft. In other words, thelongitudinal axis of the pulley arrangement is parallel to thelongitudinal axis of shaft 102. The longitudinal axis of pulleyarrangement 304 is the axis which connects the centre of pulley 305 withthe centre of pulley 306.

Driving elements pair E1, E2 engage pulley 305 of pulley arrangement304. Pulley 305 receives driving elements E1, E2 from shaft 102. Drivingelements E1, E2 are seated in the grooved edge of pulley 305. Thisconstrains driving element pair E1, E2 to move around the pulley. Asviewed from the articulation end of the shaft, driving element pair E1,E2 is wound around the far side of pulley 305. In FIG. 3 , drivingelements E1, E2 are formed of opposed portions of a single elongateelement. This single elongate element loops around the pulley 305. Inthe arrangement of FIG. 3 , the only element which driving element pairE1, E2 engages with which causes the direction of driving elements E1,E2 to change is pulley 305. In other words, driving element pair E1, E2does not engage with any further pulleys or other elements at theproximal end of the shaft which cause the direction of driving elementsE1, E2 to change. Suitably, driving element pair E1, E2 engages solelywith pulley 305 in the proximal end of the shaft. Suitably, drivingelement pair E1, E2 does not engage with any other pulleys in theproximal end of the shaft.

Driving elements pair E3, E4 engage pulley 306 of pulley arrangement304. Pulley 306 receives driving elements E3, E4 from shaft 102. As thedriving element E3 extends from the articulation 103 through the shaft102, it first reaches pulley 311. Pulley 311 is located at the proximalend of the shaft further from the articulation than the pulleyarrangement 304. Thus, driving element E3 extends through the shaft fromthe articulation beyond the pulley arrangement 304 to pulley 311. Pulley311 is mounted transverse to pulley arrangement 304. The axis 313 aboutwhich pulley 311 rotates is perpendicular to the axis 309 about whichpulley 306 rotates. Driving element E3 is seated in the grooved edge ofpulley 311. This constrains driving element E3 to move around pulley311. Pulley 311 causes the direction of driving element E3 to change by180°. Driving element E3 approaches pulley 311 from the articulation 103in a direction parallel to the longitudinal direction of the shaft.After engaging with pulley 311, driving element leaves pulley 311 in adirection parallel to the longitudinal direction of the shaft towardsthe articulation 103. Driving element E3 leaves pulley 311 and engageswith pulley 306 of pulley arrangement 304.

As the driving element E4 extends from the articulation 103 through theshaft 102, it first reaches pulley 312. Pulley 312 is located at theproximal end of the shaft further from the articulation than the pulleyarrangement 304. Thus, driving element E4 extends through the shaft fromthe articulation beyond the pulley arrangement 304 to pulley 312. Pulley312 is mounted transverse to pulley arrangement 304. The axis 314 aboutwhich pulley 312 rotates is perpendicular to the axis 309 about whichpulley 306 rotates. Pulley 312 is mounted parallel to pulley 311.Circular faces of pulleys 311 and 312 are facing each other. The axis313 about which pulley 311 rotates and the axis 314 about which pulley312 rotates are parallel. Suitably, axes 312 and 314 are collinear.Driving element E4 is seated in the grooved edge of pulley 312. Thisconstrains driving element E4 to move around pulley 312. Pulley 312causes the direction of driving element E4 to change by 180°. Drivingelement E4 approaches pulley 312 from the articulation 103 in adirection parallel to the longitudinal direction of the shaft. Afterengaging with pulley 312, driving element leaves pulley 312 in adirection parallel to the longitudinal direction of the shaft towardsthe articulation 103. Driving element E4 leaves pulley 312 and engageswith pulley 306 of pulley arrangement 304.

Driving elements E3, E4 are seated in the grooved edge of pulley 306.This constrains driving element pair E3, E4 to move around the pulley.As viewed from the articulation end of the shaft: driving element E3 iswound around the far side of pulley 311; driving element E4 is woundaround the far side of pulley 312; and driving element pair E3, E4 iswound around the near side of pulley 306. In FIG. 3 , driving elementsE3, E4 are formed of opposed portions of a single elongate element. Thissingle elongate element loops around the pulley 306. In the arrangementof FIG. 3 , the only elements which driving element pair E1, E2 engagewith which causes the direction of driving elements E1, E2 to change arepulleys 311, 312 and 306. In other words, driving element pair E3, E4does not engage with any further pulleys or other elements at theproximal end of the shaft which cause the direction of driving elementsE3, E4 to change. Suitably, driving element pair E3, E4 engages solelywith pulleys 311, 312 and 306 in the proximal end of the shaft.Suitably, driving element pair E3, E4 does not engage with any otherpulleys in the proximal end of the shaft.

The driving mechanism illustrated in FIG. 3 comprises three drives: 301,302 and 303. First drive 301 is connected to driving element pair E1,E2. First drive 301 may be connected to driving element pair E1, E2anywhere along the section of driving element pair E1, E2 which is inthe proximal end of the shaft 102. First drive 301 drives the drivingelement pair E1, E2 such that when driven in one direction E1 istensioned and E2 is de-tensioned, and when driven in the other directionE2 is tensioned and E1 is de-tensioned. The de-tensioning may bereleasing tension from the driving element. In other words, relaxing thedriving element. However, suitably, the de-tensioning is a compression.In other words, the drive 301 both pulls one driving element and pushesthe other driving element of the pair concurrently. First drive 301 maybe any suitable drive which is capable of engaging with the drivingelement pair E1, E2 in this way. For example, first drive 301 may be alinear drive. This may be implemented using a motor and a lead screwarrangement.

Second drive 302 may be connected to driving element pair E3, E4anywhere along the section of driving element pair E3, E4 which is inthe proximal end of the shaft 102. Second drive 302 drives the drivingelement pair E3, E4 such that when driven in one direction E3 istensioned and E4 is de-tensioned, and when driven in the other directionE4 is tensioned and E3 is de-tensioned. The de-tensioning may bereleasing tension from the driving element. In other words, relaxing thedriving element. However, suitably, the de-tensioning is a compression.In other words, the drive 302 both pulls one driving element and pushesthe other driving element of the pair concurrently. Second drive 302 maybe any suitable drive which is capable of engaging with the drivingelement pair E3, E4 in this way. For example, second drive 302 may be alinear drive. This may be implemented using a motor and a lead screwarrangement.

Pulley drive 303 is attached to pulley arrangement 304. Pulley drive 303displaces pulley arrangement 304 as a whole. In other words, pulleydrive 303 displaces pulley 305, pulley 306 and arm 307 as a unit. Pulleydrive 303 couples the motion of driving element pair E1, E2 and drivingelement pair E3, E4. Pulley drive 303 displaces pulley arrangement 304such that when driven in one direction driving element pair E1, E2 aretensioned and driving element pair E3, E4 are de-tensioned. Conversely,when pulley drive 303 displaces pulley arrangement 304 in the otherdirection driving element pair E3, E4 are tensioned and driving elementpair E1, E2 are de-tensioned. The de-tensioning may be releasing tensionfrom the driving element pair. In other words, relaxing the drivingelement pair. However, suitably, the de-tensioning is a compression. Inother words, pulley drive 303 both pulls one driving element pair andpushes the other driving element pair concurrently. Pulley drive 303suitably enables the described tensioning and de-tensioning of thedriving element pairs by displacing the pulley arrangement 304 linearly.Suitably, this displacement is in a direction parallel to the axis 310which connects the centres of pulleys 305 and 306. Suitably, thedisplacement is in a direction which is parallel to the longitudinalaxis of the shaft 102. Pulley drive 303 may be any suitable drive whichis capable of engaging with the driving element pairs E1, E2 and E3, E4in this way. For example, pulley drive 303 may be a linear drive. Thismay be implemented using a motor and a lead screw arrangement.

FIG. 4 illustrates a configuration in which the driving mechanism ofFIG. 3 is used to drive an articulation 103 at the distal end of theinstrument shaft 102. Articulation 103 is as described with reference toFIG. 2 . The articulation comprises a plurality of joints forarticulating an end effector. The end effector comprises two opposingjaws. One of these jaws is rigidly attached to capstan 202. The otherjaw of the end effector is rigidly attached to capstan 203. The jointsof the articulation 103 are driven by the driving element pairs E1, E2and E3, E4 of FIG. 3 . Driving element pairs E1, E2 and E3, E4 engagethe driving mechanism 300 as described with reference to FIG. 3 .Driving element pairs E1, E2, and E3, E4 extend through the hollow shaft102 to the articulation 103 at the distal end of the shaft. Drivingelement pairs E1, E2 and E3, E4 engage with the articulation 103 at thedistal end of the shaft as described with reference to FIG. 2 , where E1and E2 correspond to C3 and C4, and E3 and E4 correspond to C1 and C2.

The articulation is a wrist articulation, which includes pitch joint204. Rotation about pitch joint 204 causes the wrist, and hence the endeffector 104, to pitch relative to the shaft 102. Pitch joint 204 iscaused to rotate in the direction marked 401 by tensioning drivingelement pair E3, E4 and de-tensioning or compressing driving elementpair E1, E2. This is achieved by pulley drive 303 driving the pulleyarrangement 304 so as to displace the pulley arrangement towards thearticulation 301. Suitably, the pulley drive 303 linearly displaces thepulley arrangement 304 towards the distal end of the shaft. Conversely,pitch joint 204 is caused to rotate in the opposing direction marked 402by tensioning driving element pair E1, E2 and de-tensioning orcompressing driving element pair E3, E4. This is achieved by pulleydrive 303 driving the pulley arrangement 304 so as to displace thepulley arrangement away from the articulation 301. Suitably, the pulleydrive 303 linearly displaces the pulley arrangement 304 away from thedistal end of the shaft.

Rotation about capstan 202 causes a first jaw of the end effector torotate about the central axis 403 of capstan 202. The first jaw iscaused to rotate in the direction marked 401 by tensioning drivingelement E3 and de-tensioning or compressing driving element E4. This isachieved by second drive 302 driving driving element pair E3, E4 in onedirection. Conversely, the first jaw is caused to rotate in the opposingdirection marked 402 by tensioning driving element E4 and de-tensioningor compressing driving element E3. This is achieved by second drive 302driving driving element pair E3, E4 in an opposing direction to thatdiscussed above. The tension status of driving elements E1 and E2 areimmaterial to driving rotation of the first jaw about capstan 202. Themotions of driving element pair E1, E2 and driving element pair E3, E4are not coupled when driving rotation about capstan 202.

Rotation about capstan 203 causes a second jaw of the end effector torotate about the central axis 404 of capstan 203. Central axis 404 ofcapstan 203 is parallel to central axis 403 of capstan 202. Suitably,central axis 404 of capstan 203 is collinear with central axis 403 ofcapstan 202. The second jaw is caused to rotate in the direction marked401 by tensioning driving element E1 and de-tensioning or compressingdriving element E2. This is achieved by first drive 301 driving drivingelement pair E1, E2 in one direction. Conversely, the second jaw iscaused to rotate in the opposing direction marked 402 by tensioningdriving element E2 and de-tensioning or compressing driving element E1.This is achieved by first drive 301 driving driving element pair E1, E2in an opposing direction to that discussed above. The tension status ofdriving elements E3 and E4 are immaterial to driving rotation of thesecond jaw about capstan 203. The motions of driving element pair E1, E2and driving element pair E3, E4 are not coupled when driving rotationabout capstan 203. The driving mechanism 300 independently drives motionof pitch joint 204 and each of the jaws by capstans 202 and 203. One orboth jaws may be actuated concurrently with pitching the wrist bydriving the driving elements E1, E2, E3 and E4 as described above.

The driving elements E1, E2, E3 and E4 are flexible. Each drivingelement is elongate. Each driving element can be flexed laterally to itsmain extent. In other words, each driving element can be flexedtransversely to its longitudinal axis. Each driving element is notflexible along its main extent. Each driving element resists compressionand tension forces acting in the direction of its longitudinal axis.Thus, the driving elements are able to transfer drive from the proximalend of the instrument to the articulation. The driving elements may becables.

Each driving element illustrated in FIG. 4 is rigidly secured to thecapstan about which it terminates in the articulation. In FIG. 4 , thedriving elements are not rigidly secured to any other element of theinstrument. In FIG. 4 , driving element pair E1, E2 is a single elongateloop which is rigidly fixed to capstan 202. This loop is fixed tocapstan 202 at the point on capstan 202 which is most distal to thedriving mechanism 300 and lies on the longitudinal axis of the shaftwhen the end effector, articulation and shaft are in the straightconfiguration shown in FIG. 4 . Similarly, in FIG. 4 , driving elementpair E3, E4 is a single elongate loop which is rigidly fixed to capstan203. This loop is fixed to capstan 203 at the point on capstan 203 whichis most distal to the driving mechanism 300 and lies on the longitudinalaxis of the shaft when the end effector, articulation and shaft are inthe straight configuration shown in FIG. 4 .

In an alternative configuration, driving elements E1 and E2 may bedisconnected at the articulation. In other words, driving elements E1and E2 may not form a continuous element about the capstan 203. Instead,driving elements E1 and E2 may each individually terminate at capstan203, to which they are individually secured. Driving elements E1 and E2may also be disconnected at the pulley arrangement. In other words,driving elements E1 and E2 may not form a continuous element about thepulley 306. Instead, driving elements E1 and E2 may each individuallyterminate at pulley 306, to which they are individually secured.

Similarly, driving elements E3 and E4 may be disconnected at thearticulation. In other words, driving elements E3 and E4 may not form acontinuous element about the capstan 202. Instead, driving elements E3and E4 may each individually terminate at capstan 202, to which they areindividually secured. Driving elements E3 and E4 may also bedisconnected at the pulley arrangement. In other words, driving elementsE3 and E4 may not form a continuous element about the pulley 305.Instead, driving elements E3 and E4 may each individually terminate atpulley 305, to which they are individually secured.

FIGS. 3 and 4 illustrate an example of a driving mechanism includingonly four pulleys: pulleys 305 and 306 of the pulley arrangement andpulleys 311 and 312. Further pulleys may additionally be utilised in theinstrument to engage with the driving elements. For example, furtherpulleys may be used to ease the driving elements around each other toprevent them from rubbing against each other. Further pulleys may beused to ease one or more of the driving elements around other obstaclesin the interior of the instrument, for example suturing thread, anoptical fibre, an endoscopic camera. Suitably, each driving elementretains its motion substantially parallel to the longitudinal axis ofthe instrument shaft despite the additional pulleys.

It may be desirable for the driving mechanism to be located in adifferent orientation or location at the proximal end of the instrumentshaft in order to utilise the space in the central interior area of theinstrument shaft for other components. In this case, additional pulleysmay be used compared to FIG. 3 to locate the driving mechanism in thealternative orientation/location. This alternative orientation/locationmay be such that the axis 310 connecting the centres of the pulleys inthe pulley arrangement is no longer parallel to the longitudinal axis ofthe instrument shaft. The pulley drive causes the pulley arrangement tomove in a linear direction parallel to the axis 310 connecting thecentres of the pulleys in the pulley arrangement. However, this linearmovement may no longer be parallel to the longitudinal axis of theinstrument shaft. However, by means of the additional pulleys, the samemotions of the driving elements in the shaft are achieved by driving thepulley drive and the first and second drives.

The two pulleys 305 and 306 of the pulley arrangement 304 of FIG. 3 areconnected by arm 307. However, any suitable connecting means may be usedinstead of the arm 307, as long as that connecting means maintains thepulleys 305 and 306 at a fixed separation from each other.

FIG. 4 illustrates the driving mechanism of FIG. 3 driving anarticulation 103 at the distal end of the instrument shaft 102. Thedriving mechanism of FIG. 3 may be used to drive other configurations ofarticulation at the distal end of an instrument shaft. The drivingmechanism of FIG. 3 can drive any articulation which is driveable withtwo pairs of driving elements which are capable of transferring motionas described herein.

The apparatus described herein enables motion of two pairs of drivingelements as described herein utilising only three drives, instead of thefour drives shown in FIG. 2 . This enables the instrument to be lighterweight, and frees up additional space inside the instrument shaft forother components, or alternatively enables a shaft with a narrowerdiameter to be used.

It will be appreciated that the driving mechanism described herein couldbe modified to include further driving elements to transfer drive tofurther joints of an articulation at the distal end of the instrumentshaft.

The driving mechanism 300 of FIG. 3 is substantially planar. The pulleys305 and 306 and arm 307 are located in parallel planes. Pulleys 311 and312 are located transverse to the plane of pulley arrangement 304. Thisresults in the driving elements E1, E2, E3 and E4 being aligned. Inother words, driving elements E1, E2, E3 and E4 are parallel to eachother.

FIG. 5 illustrates a schematic drawing of a further exemplary drivingmechanism 500 of the interior of a robotic surgical instrument at theend of the surgical instrument distal from the end effector. The drivingmechanism 500 may be used to drive an articulation 103 at the distal endof the instrument shaft 102 as described above with respect to FIG. 4 .The driving mechanism 500 of FIG. 5 is as described above with respectto the driving mechanism 300 of FIG. 3 , except that the pulleys 511 and512 have different orientations to the pulleys 311 and 312. Pulleys 511and 512 are not mounted transverse to pulley arrangement 304. Pulleyaxis 513 of pulley 511 is not perpendicular to pulley axes 308 and 309of pulleys 305 and 306. Pulley axis 514 of pulley 512 is notperpendicular to pulley axes 308 and 309 of pulleys 305 and 306. Pulleys511 and 512 are not parallel to each other. This results in the drivingelements E1, E2, E3 and E4 not all being aligned with each other. Inother words, driving elements E1, E2, E3 and E4 are not all parallel toeach other as they extend towards a distal articulation. The angle ofthe pulleys 511, 512 may be so as to direct the driving elements E3, E4towards the parts of the distal articulation of the instrument that theyengage with. Causing the driving elements to be non-parallel providesadditional space for locating the drives 301, 302, 303. This providesmore engineering freedom in how the drives are designed.

The orientations of pulleys 311, 511 and pulleys 312, 512 are all suchthat they guide the driving elements E3, E4 onto the same pick up andtake off points of the pulley 306. Both pulley 311 and pulley 511 guidethe driving element E3 onto the same pick up point/take off point 515 ofpulley 306. Both pulley 312 and pulley 512 guide the driving element E4onto the same pick up point/take off point 516 of pulley 306.

Other component parts of the pulley arrangement of FIG. 3 may be in adifferent orientation to that shown in FIG. 3 or 5 . For example, pulley305 and pulley 306 may be non-parallel. Axes 308 and 309 may benon-parallel. As long as pulleys 305 and 306 move in unison with arm307, axes 308 and 309 may be angled relative to each other.

The instrument could be used for non-surgical purposes. For example itcould be used in a cosmetic procedure.

The applicant hereby discloses in isolation each individual featuredescribed herein and any combination of two or more such features, tothe extent that such features or combinations are capable of beingcarried out based on the present specification as a whole in the lightof the common general knowledge of a person skilled in the art,irrespective of whether such features or combinations of features solveany problems disclosed herein, and without limitation to the scope ofthe claims. The applicant indicates that aspects of the presentinvention may consist of any such individual feature or combination offeatures. In view of the foregoing description it will be evident to aperson skilled in the art that various modifications may be made withinthe scope of the invention.

What is claimed is:
 1. A robotic surgical instrument comprising: ashaft; an articulation attached to the distal end of the shaft, thearticulation comprising a plurality of joints configured to articulatean end effector, the plurality of joints driveable by at least first andsecond pairs of driving elements; and a driving mechanism at theproximal end of the shaft, the driving mechanism comprising: a pulleyarrangement comprising first and second pulleys attached together suchthat their separation is fixed, wherein the first pair of drivingelements is constrained to move around the first pulley, and the secondpair of driving elements is constrained to move around the secondpulley; third and fourth pulleys around which the second pair of drivingelements is further constrained to move, wherein the third and fourthpulleys are mounted such that their pulley axes are non-parallel andnon-perpendicular to the pulley axes of the of the first and secondpulleys; and a pulley drive configured to displace the pulleyarrangement, such that a displacement in one direction causes the firstpair of driving elements to be tensioned and the second pair of drivingelements to be de-tensioned, and a displacement in an opposing directioncauses the second pair of driving elements to be tensioned and the firstpair of driving elements to be de-tensioned.
 2. The robotic surgicalinstrument as claimed in claim 1, wherein the third and fourth pulleysare mounted such that their pulley axes are non-parallel to each other.3. The robotic surgical instrument as claimed in claim 1, wherein thethird and fourth pulleys are located further from the articulation thanthe pulley arrangement, wherein the second pair of driving elementsextends from the articulation through the shaft, around the third andfourth pulleys to the second pulley, such that when the pulley drivedisplaces the pulley arrangement towards the distal end of the shaft,the second pair of driving elements is tensioned.
 4. The roboticsurgical instrument as claimed in claim 3, wherein a separation,transverse to the longitudinal direction of the shaft, between eachdriving element of the second pair of driving elements between the thirdand fourth pulleys and the articulation, is smaller than a separation,transverse to the longitudinal direction of the shaft, between eachdriving element of the first pair of driving elements between the firstpulley and the articulation.
 5. The robotic surgical instrument asclaimed in claim 1, wherein the third and fourth pulleys are angled suchthat the distance between a pick up/take off point of the third pulleyand a pick up/take off point of the fourth pulley is less than thedistance between the pick up/take off points of the first pulley.
 6. Therobotic surgical instrument as claimed in claim 1, wherein the first andsecond pulleys are mounted such that their pulley axes are non-parallelto each other.
 7. The robotic surgical instrument as claimed in claim 1,wherein the pulley drive is configured to displace the pulleyarrangement such that a displacement in one direction causes the firstpair of driving elements to be tensioned and the second pair of drivingelements to be compressed, and a displacement in an opposing directioncauses the second pair of driving elements to be tensioned and the firstpair of driving elements to be compressed.
 8. The robotic surgicalinstrument as claimed in claim 1, wherein the articulation is a wristarticulation and one of the plurality of joints is a pitch jointconfigured to pitch the wrist articulation, the first and second pairsof driving elements being connected to the wrist articulation such thatwhen the pulley drive displaces the pulley arrangement in one directionthe wrist articulation pitches in one direction about the pitch joint,and when the pulley drive displaces the pulley arrangement in theopposing direction the wrist articulation pitches in an opposingdirection about the pitch joint.
 9. The robotic surgical instrument asclaimed in claim 1, wherein the pulley drive is configured to displacethe pulley arrangement in a direction parallel to the longitudinal axisof the shaft.
 10. The robotic surgical instrument as claimed in claim 1,wherein the pulley drive is configured to linearly displace the pulleyarrangement, such that a linear displacement in a direction away fromthe distal end of the shaft causes the first pair of driving elements tobe tensioned and the second pair of driving elements to be de-tensioned,and a linear displacement in an opposing direction towards the distalend of the shaft causes the second pair of driving elements to betensioned and the first pair of driving elements to be de-tensioned. 11.The robotic surgical instrument as claimed in claim 1, wherein at theproximal end of the shaft, the first pair of driving elements isconstrained to move around the first pulley only with no furtherintervening pulleys, such that when the pulley drive displaces thepulley arrangement away from the distal end of the shaft, the first pairof driving elements is tensioned.
 12. The robotic surgical instrument asclaimed in claim 1, the driving mechanism further comprising a firstdrive configured to drive the first pair of driving elements, such thata drive applied in one direction causes a first one of the first pair ofdriving elements to be tensioned and a second one of the first pair ofdriving elements to be compressed, and a drive applied in an opposingdirection causes the first one of the first pair of driving elements tobe compressed and the second one of the first pair of driving elementsto be tensioned.
 13. The robotic surgical instrument as claimed in claim12, wherein one of the plurality of joints is configured to actuateopposing first and second jaws of an end effector, the first pair ofdriving elements being connected to the articulation such that when thefirst drive applies a drive in one direction the first jaw rotates inone direction about that joint, and when the first drive applies a drivein an opposing direction the first jaw rotates in an opposing directionabout that joint.
 14. The robotic surgical instrument as claimed inclaim 12, wherein the first drive is a linear drive.
 15. The roboticsurgical instrument as claimed in claim 1, the driving mechanism furthercomprising a second drive configured to drive the second pair of drivingelements, such that a drive applied in one direction causes a first oneof the second pair of driving elements to be tensioned and a second oneof the second pair of driving elements to be compressed, and a driveapplied in an opposing direction causes the first one of the second pairof driving elements to be compressed and the second one of the secondpair of driving elements to be tensioned.
 16. The robotic surgicalinstrument as claimed in claim 15, wherein one of the plurality ofjoints is configured to actuate opposing first and second jaws of an endeffector, the second pair of driving elements being connected to thearticulation such that when the second drive applies a drive in onedirection the second jaw rotates in one direction about that joint, andwhen the second drive applies a drive in an opposing direction thesecond jaw rotates in an opposing direction about that joint.
 17. Therobotic surgical instrument as claimed in claim 15, wherein the seconddrive is a linear drive.
 18. The robotic surgical instrument as claimedin claim 1, wherein each pair of driving elements is formed of opposedportions of a single elongate element secured to one of the plurality ofjoints of the articulation.
 19. The robotic surgical instrument asclaimed in claim 1, wherein each driving element of the first pair ofdriving elements is formed of a distinct elongate element secured to oneof the plurality of joints of the articulation and secured to the firstpulley.
 20. The robotic surgical instrument as claimed in claim 1,wherein each driving element of the second pair of driving elements isformed of a distinct elongate element secured to one of the plurality ofjoints of the articulation and secured to the second pulley.